Differentiation of Cerebral Dissecting Aneurysm from Hemorrhagic Saccular Aneurysm by Machine-Learning Based on Vessel Wall MRI: A Multicenter Study

Abstract

The differential diagnosis of a cerebral dissecting aneurysm (DA) and a hemorrhagic saccular aneurysm (SA) often depends on the intraoperative findings; thus, improved non-invasive imaging diagnosis before surgery is essential to distinguish between these two aneurysms, in order to provide the correct formulation of surgical procedure. We aimed to build a radiomic model based on high-resolution vessel wall magnetic resonance imaging (VW-MRI) and a machine-learning algorithm. In total, 851 radiomic features from 146 cases were analyzed retrospectively, and the ElasticNet algorithm was used to establish the radiomic model in a training set of 77 cases. A clinico-radiological model using clinical features and MRI features was also built. Then an integrated model was built by combining the radiomic model and clinico-radiological model. The area under the ROC curve (AUC) was used to quantify the performance of models. The models were evaluated using leave-one-out cross-validation in a training set, and further validated in an external test set of 69 cases. The diagnostic performance of experienced radiologists was also assessed for comparison. Eight features were used to establish the radiomic model, and the radiomic model performs better (AUC = 0.831) than the clinico-radiological model (AUC = 0.717), integrated model (AUC = 0.813), and even experienced radiologists (AUC = 0.801). Therefore, a radiomic model based on VW-MRI can reliably be used to distinguish DA and hemorrhagic SA, and, thus, be widely applied in clinical practice.

The Use of HU Thresholding in Carotid-Cerebral CT Angiography: A Qualitative Study

“…These two things depend on the type of blood vessels being examined and the ability of the modality to do two fast scans. Brain blood vessels incorporated in the Circulus of Willis have a high flow rate due to the location of blood vessels that are very close to the center of the heart and have a fairly small caliber (13). So, it takes the right time and synchronous between peak enhancement of contrast media administration with detection carried out by CT-Scan modality (8).…”

“…Magnetic resonance (MR) angiography has also been reported to be useful in the diagnosis of brain aneurysms(1214), but generally more time-consuming than 3D CTA, and MRI is very sensitive to movement artifacts. In addition, some aneurysms are not well demonstrated by MR angiography because of turbulent or slow vascular flow (12,13,15).…”